- MeSH
- geografická atrofie diagnostické zobrazování patologie MeSH
- jizva diagnostické zobrazování patologie MeSH
- lidé MeSH
- makulární degenerace * diagnostické zobrazování klasifikace patologie MeSH
- neovaskularizace choroidey diagnostické zobrazování komplikace patologie MeSH
- retinální drúzy diagnostické zobrazování klasifikace patologie MeSH
- retinální krvácení diagnostické zobrazování etiologie MeSH
- retinální pigmentový epitel patologie MeSH
- ruptura diagnostické zobrazování etiologie patologie MeSH
- vlhká makulární degenerace diagnostické zobrazování patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Injuries of the flexor finger apparatus are very common. Primarily, it is routinely treated by suture of the tendon. Isolated deep flexor injuries, when the flexion restriction only reaches the DIP joint, are sometimes overlooked by the surgeon or by the patients themselves, especially if the deep flexor is injured, after a closed rupture or cutaneous injury with a small skin wound. The patient is then sent to a department specializing in hand surgery after a few weeks. Subsequent shortening of the tendon apparatus makes flexor suture more difficult or sometimes even impossible. Many ways of suturing the tendons and subsequent treatment are described. The treatment results vary immensely. It depends on the mechanism of injury, injury zone, the suture suture technique used, time that has elapsed since primary treatment, surgeon experience and subsequent postoperative and rehabilitative care. One of them is reconstruction of the flexor apparatus by primary transplantation of an autologous tendon graft. Most commonly, the tendon graft is taken from the palmaris longusfrom the same hand. The tendon graft can subsitute the entire area of zones I and II. The tendon suture is made in the palm proximal to the A1 pulley outside the tendon sheath in the area where the muscular belly of thelumbricalis is located on the tendon of the deep flexor. The distal end is reinserted to the base of the distal phalanx. The primary use of the autologous tendon graft can be used in the reconstruction of obsolete deep-flexor injuries in Zone II, but also in primary treatments. This type of treatment has a number of advantages. Performing the reinforcement of the tendon at the base of the distal phalanxand the suture in the palm of the hand completely eliminates the complications caused by the tendon suture in zone II. There is no injury to the tendon sheath, or the need for intersection of the tendons. The transplanted tendon is smaller in diameter than the deep flexor, so it can also be used for older injuries when the tendon sheath is in partially missing. It removes painful palmar resistance by restoring the right position and a tension of tendon of lumbricalis and the tendon of the deep flexor. This type of reconstruction allows immediate active or semi-rehabilitation of the hand and fingers. Key words:tendon, injury, hand, transplantation, surgery, flexor, reconstruction, rupture, treatment.
- MeSH
- autologní štěp transplantace MeSH
- kosterní svaly chirurgie MeSH
- lidé MeSH
- poranění prstů ruky rehabilitace chirurgie MeSH
- poranění ruky patologie rehabilitace chirurgie MeSH
- poranění šlachy chirurgie MeSH
- prsty ruky patologie transplantace MeSH
- rozsah kloubních pohybů fyziologie MeSH
- ruptura patologie chirurgie MeSH
- šicí techniky normy MeSH
- šlachy patologie transplantace MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF THE STUDY The purpose of the prospective randomised study was to assess the benefits of the platelet-rich fibrin (PRF) application during the anatomic anterior cruciate ligament reconstruction (ACLR) for tendon graft healing. MATERIAL AND METHODS The study included 40 patients with an isolated rupture of the anterior cruciate ligament in the knee. The MRI findings on the tendon graft were evaluated at 6 months and 12 months after the surgery in a total of 33 patients, namely in 10 women/23 men (21 right knee/12 left knee), with the mean age of 29.1 years and at the mean follow-up of 15.9 weeks after the injury. The randomisation using envelopes was carried out at the beginning of arthroscopy either in the group with the PRF application (Group 1) (17 patients) or in the group without the PRF application (Group 2) (16 patients). The followed-up patients underwent the ACLR with targeting the femoral tunnel through anteromedial portal using the autografts of m. semitendinosusand m. graciliswith Tightrope femoral fixation and Inion implant in tibia. In Group 1, during the surgery PRF was applied both in the drilled tunnels (intraosseously) and directly to the surface of the tendon graft itself (intraarticular part). The Group 2 was a control group in which the same intervention was performed, however without the PRF application. In the 6 th and 12 th month after the surgery, the signal intensity of the knee and occurrence of the ACL graft failure, bone (marrow) oedema rate near the tunnels were assessed by an independent radiologist using a 3 Tesla MRI. RESULTS In the 6 th and also in the 12 th postoperative month, neither a complete, nor a partial graft failure was found in the group with PRF, whereas in Group 2 a complete or a partial graft failure was observed in 12.5% (p = 0.23). In the 6th month, a bone marrow oedema near the intraosseous parts of the graft was reported in 94.1% of patients in Group 1 and in 81.3% of patients in Group 2, while in the 12 th month it was 23.5% of evaluated patients in Group 1 and 37.5% patients in Group 2. The differences between the two groups were not statistically significant in the 6 th (p = 0.096) or in the 12 th month (p = 0.43). In the 6 th month, a fully ligamentised graft was found in 52.9% of patients in Group 1 and in 37.5% of patients in Group 2 (p = 0.061), a partially ligamentised graft was present in 47.1% of patients in Group 1 and in 50% of patients in Group 2. In the 12 th month, a fully ligamentised graft was seen in 94.1% of patients in Group 1 and in 75% of patients in Group 2 (p = 0.26) and a partially ligamentised graft was present in 5.9% of patients in Group 1 and in 12.5% of patients in Group 2. In the remaining 12.5% of patients in Group 2, the finding was assessed as a graft with no signs of ligamentisation. DISCUSSION We have not encountered a paper in the Czech or world literature which would present results of a similar study, i.e. which would evaluate the potential benefits of the platelet-rich fibrin application in the course of the anatomic anterior cruciate ligament reconstruction. Majority of studies evaluate the benefits of the application of platelet-rich plasma aimed to achieve a positive effect on the LCA graft healing. CONCLUSIONS Our study proved a higher percentage of ligamentisation and healed grafts into the bone as well as a lower occurrence of graft failure in the group with PRF compared to the group without the PRF application, namely both in the 6 th and in the 12 th month. Nonetheless, the differences between the two groups assessed at the same time were not statistically significant. Key words: anterior cruciate ligament, arthroscopy, anatomic ACL reconstruction, magnetic resonance imaging of the graft, platelet-rich fibrin, graft healing, MRI signal intensity of the graft.
- MeSH
- artroskopie MeSH
- autologní transplantace MeSH
- dospělí MeSH
- femur chirurgie MeSH
- fibrin bohatý na krevní destičky fyziologie MeSH
- kolenní kloub diagnostické zobrazování patologie chirurgie MeSH
- lidé MeSH
- ligamentum cruciatum anterius patologie MeSH
- magnetická rezonanční tomografie metody MeSH
- plazma bohatá na destičky fyziologie MeSH
- poranění předního zkříženého vazu diagnostické zobrazování chirurgie MeSH
- prospektivní studie MeSH
- rejekce štěpu patologie MeSH
- rekonstrukce předního zkříženého vazu metody MeSH
- ruptura patologie MeSH
- šlachy diagnostické zobrazování transplantace MeSH
- tibie chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Česká republika MeSH
Cranial cruciate ligament (CCL) rupture is one of the most common orthopedic conditions in dogs. The pathogenesis of CCL rupture is not fully described and remains to be elucidated fully. Several hypotheses have been proposed to explain the etiology of these changes. The objective of this study was to investigate structural changes in the CCL in relation to the tibial plateau angle (TPA) and the intercondylar notch (ICN) width in dogs. Fifty-five skeletally mature dogs were included in this study. ICN width and TPA measurements were obtained from intact CCL stifles. Samples of the CCL, caudal cruciate ligament (CaCL), and femoral head ligament (FHL) were harvested and stained for routine histological and immunohistochemical analysis. Microscopic changes in the ligaments were observed and were found to correlate with the TPA and ICN width values. The degree of structural changes within the CCL was observed to correlate with an increasing TPA and a narrowing ICN width. Changes in the CCL are likely to be caused by excessive forces acting through the ligament in stifles with a high TPA. Chondroid metaplasia of the CCL is an adaptation to abnormal mechanics within the stifle joint caused by altered bone morphology.
- MeSH
- ligamentum cruciatum anterius patologie MeSH
- nemoci psů patologie MeSH
- poranění předního zkříženého vazu patologie veterinární MeSH
- psi MeSH
- ruptura patologie veterinární MeSH
- tibie patologie MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- psi MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- bronchoskopie metody MeSH
- bronchy * chirurgie diagnostické zobrazování zranění MeSH
- drenáž metody MeSH
- hemotorax chirurgie etiologie MeSH
- hrudní chirurgické výkony MeSH
- lidé MeSH
- mladiství MeSH
- počítačová rentgenová tomografie MeSH
- pooperační péče MeSH
- poranění hrudníku chirurgie diagnostické zobrazování patologie MeSH
- rentgendiagnostika hrudníku MeSH
- ruptura * chirurgie patologie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- bránice chirurgie zranění MeSH
- chirurgie operační metody MeSH
- hrudní chirurgické výkony metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- ruptura * chirurgie diagnóza etiologie patologie MeSH
- střeva * chirurgie zranění MeSH
- úrazy a nehody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- bránice * chirurgie zranění MeSH
- dopravní nehody MeSH
- hrudní chirurgické výkony metody MeSH
- lidé MeSH
- mladiství MeSH
- počítačová rentgenová tomografie MeSH
- pooperační období MeSH
- poranění hrudníku chirurgie diagnostické zobrazování etiologie patologie MeSH
- rentgendiagnostika hrudníku MeSH
- ruptura * chirurgie diagnostické zobrazování etiologie patologie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- bránice * chirurgie zranění MeSH
- dopravní nehody MeSH
- hrudní chirurgické výkony metody MeSH
- lidé MeSH
- polytrauma etiologie patologie MeSH
- pooperační období MeSH
- poranění hrudníku chirurgie diagnostické zobrazování etiologie patologie MeSH
- ruptura * chirurgie diagnostické zobrazování etiologie patologie MeSH
- žaludek diagnostické zobrazování zranění MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- arteria carotis interna patofyziologie MeSH
- lidé MeSH
- náhlá smrt * MeSH
- neurofibromatóza 1 patologie MeSH
- ruptura patologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- kazuistiky MeSH
Ruptura Achillovy šlachy je poranění relativně časté, při jehož řešení dominuje operační terapie. V předkládaném článku se autoři zabývají ošetřením nekrózy této šlachy vzniklé jednak jako komplikace otevřené sutury, jednak jako následek dnavého zánětu. Operaci v jedné době, kdy je proveden důsledný débridement s resekcí nekrotické tkáně a ponecháním k sekundárnímu hojení za vytvoření silného neotenda, považují za vhodný způsob léčby s dobrými výsledky.
Rupture of the Achilles tendon is relatively common injury, treated primarily by surgical intervention. In the present article, the authors deal with necrosis of the Achilles tendon, as a complication arising from open suturing or as a result of gout inflammation. Consistent debridement and resection of necrotic tendon in one session leaving secondary healing for creating a strong neotendon, are considered to be suitable therapeutic methods, with good results.
- MeSH
- Achillova šlacha * chirurgie patologie MeSH
- debridement MeSH
- dna (nemoc) komplikace MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nekróza * etiologie chirurgie MeSH
- poranění šlachy etiologie chirurgie komplikace patologie MeSH
- ruptura chirurgie patologie MeSH
- sutura MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH